Wouldn’t It Be Great If…

This year at RD we decided to think big about the New Year, and we’ve come up with a list of resolutions for the whole country. We know, we know — it’s a little presumptuous. There are a lot of tough problems that no one is going to solve in a mere 12 months — Social Security, homelessness, unemployment. Still, we found seven issues we thought most of us could agree on. And if we put our backs to it, we could get fast action on them as well.

1. “Ask not what your country can do for you…” Whether you’re a liberal or a conservative, a Republican or a Democrat, there’s one thing we can all agree on — this is a great country. And each of us owes it a great debt. That’s why we’ve made a national service requirement the No. 1 pick on our list. At some point between the ages of 18 and 25, everyone should give up to a year to America. Join the military or ROTC, teach in a poor school, suit up with a disaster relief team, work in the forests or national parks, help elderly shut-ins or the handicapped. About four million people turn 18 every year. Think of everything they could accomplish. In return they’d get a stipend for living expenses and a college-tuition credit.

Obviously this isn’t a new idea; JFK’s “Ask what you can do for your country” speech was over 40 years ago. And more than 80 million Americans already do volunteer work. Civil libertarians would likely sue to overturn any mandatory service requirement. Fiscal conservatives would complain about the cost, which could certainly run to $20 billion or more a year. And as one critic puts it, “Involuntary voluntarism is like hot snow.” Sure, but… An analysis of AmeriCorps, a volunteer program with a broad spectrum of political support, estimated that every dollar invested returned $1.66 in benefits.

A national service would also create amazing intangible benefits — lives and communities transformed, a sense of accomplishment and connection, and what Senator John McCain has called “a glimpse at the glory of serving the cause of freedom.” We’ll say yes to all that.

2. Stop the Lawsuit Insanity Unprovable pain and suffering awards that medical malpractice juries hand out cost society billions in the long run, and often reward lawyers more than the victims. Adding insult to injury, the awards drive huge premiums for malpractice insurance, contributing to the spiral of health care costs. And at a time when we need more physicians, the malpractice mess is driving doctors from risky but critical specialties, like ob-gyn and trauma care. In some high litigation states, such as Illinois and Pennsylvania, doctors are moving elsewhere, or simply quitting.

Much of this would go away if the states all put caps on pain and suffering awards. California has had a $250,000 cap since 1975 — and stable malpractice insurance rates. The point is to set limits on the noneconomic losses due to medical injury or malpractice. Awards for actual damages — the type of injuries that kill or maim, resulting in genuine economic losses — would continue to be litigated. Those awards could still be considerable, or even huge in cases of wrongful death. But payouts for emotional distress and loss of companionship, typical pain and suffering issues, would no longer drive galloping malpractice rates. Doctors and insurers would also save on the astounding costs associated with this type of litigation.

A 2003 Congressional study concluded that a $250,000 cap would help curb the rise in medical costs by reducing the number of tests motivated by fear of litigation, and could save the federal government $67 billion over 10 years. Doctors have long campaigned for malpractice caps. But in return, medical boards and associations should be forced to disclose more information about genuine cases of malpractice — and be more vigilant in punishing truly incompetent doctors. After all, it’s a few bad doctors who make things worse for everyone. In New York, for instance, 68 percent of malpractice payouts are attributable to a mere 7 percent of the state’s physicians.

3. Reverse a Shameful TrendIt’s one of the most stupid problems we have — drunk driving is actually on the rise. Each year it kills 17,000 people, and is the No. 2 cause of accidental death.

The nine states that haven’t done so should adopt Administrative License Revocation (ALR) statutes. If you’re arrested for drunk driving — or refuse to take a sobriety test — your permanent license gets confiscated. At the police station you’ll be issued a temporary, limited driving permit. If you’re found guilty at an administrative hearing, you could lose your license for up to a year. These laws get broad support from police, insurers and public health experts. More important, they work, typically resulting in a 9 percent drop in alcohol-related fatalities. Their deterrent effect saves money too. After they adopted ALR laws, both Nevada and Mississippi saw their costs related to nighttime car accidents — EMS, police, etc. — fall by tens of millions of dollars.

While they’re at it, legislators in the 14 states that still allow open containers of alcohol in cars should fix those laws. They’re an invitation to drink and drive — something 15 percent of us say we’ve done in the last month.